Ukuqonda indlela kwaye kutheni i-organ resistance rejected after transplantation kubalulekile ukuba ayiqonde nje kuphela inkqubo yokufakelwa komzimba , kodwa kunye nolwazi olubalulekileyo malunga nesistim somzimba, izixhobo ezahlukeneyo zabanikeli bomzimba kunye nendlela ezi zinto zibini ezinokubangela ukuba i-organ transplantation ibe nzima.
Yintoni yokuTshintshala?
Ukufakelwa kwenkqubo yonyango apho izicubu okanye isigxina zisuswa emzimbeni omnye kwaye zifakwe kwelinye umzimba ukuba zithathe indawo yelungu okanye izicubu ezingasebenzi kakuhle, azikho okanye zigula.
Ukufakelwa komzimba kuyenziwa kuphela kwizifo ezinzima. Le nqubo ayenziwanga kwizifo ezincinci okanye ezilinganayo, zenziwa xa iqumrhu ligule kangangokuthi ekugqibeleni liza kutsho kwi-dialysis okanye ukufa ngaphandle kokutshintshwa.
Iziganeko eziqhelekileyo zenziwa ngokuthatha isigungu esisuka kumzimba womntu omnye, esaphila okanye eswelekileyo, kwaye sitshintshelwe kwenye yomzimba womntu. Amalungu, izicubu ezinjenge-skin, ligaments, kunye neeton, kunye ne-cornea ephuma kweso liyakwazi ukufunyanwa kwaye kunikwe ummkeli ukuba aphathe imiba eyahlukahlukeneyo.
Kunokwenzeka ukutshintshela izicubu zezilwanyana kunye, njenge-pig okanye inkomo, kwaye uyisebenzise ummkeli womntu. Enye yezindlela eziqhelekileyo ezinokusetyenziswa ngolu hlobo lweesisisi zezigulana ezifuna i-valve yenhliziyo ithathe indawo.
Ngokomlando, izitho zokufakelwa kwezityalo zithathwe emzimbeni womntu kwaye zifakwa kwenye umzimba womntu. Kukho iziganeko ezinqabileyo zezitho ezisuswa kwi-primatic kwaye zifakwa kummkeli womntu.
Kule ndawo, ininzi edumileyo ngu-Stephanie Fae Beauclair, ngo-1984, owaziwa kangcono ngokuthi "Baby Fae," owamkela intliziyo yebhonon kwiminyaka eyi-11 ngaphambi kokuba afe ngenxa yelungu lokulahlwa kwimihla eneminyaka eyi-31.
Iintlobo zoTshintsho
Kukho iintlobo ezininzi zezinto ezihambayo kunye neluhlu olude lweendlela zokuchaza iinkqubo ezenza ukuba iziqu zenzeke.
Umngcipheko wokugatya uhluka phakathi kweentlobo zabaxhasi, njengoko ulwahlulo phakathi komnikeli nommkeli kunokwandisa amathuba okugatywa. Ngenxa yeso sizathu, ukuqonda uhlobo lokutshintshwa kunokunceda ukubeka umngcipheko wokugatywa kwaye unokukunceda iqela lokunakekelwa kwezempilo lithathe isigqibo sokuba uncedo lonyango luyimfuneko ukwenzela ukuthintela ukuthatyathwa.
Nantsi uludwe olufutshane lwegama lesizwi elisetyenziselwa iintlobo ezahlukeneyo zokufakelwa.
I-Autograft: izicubu zithathwa kwenye inxalenye yomzimba kwaye zitshintshelwe kwenye inxalenye yomzimba ofanayo. Ngokomzekelo, emva kokutshisa okukhulu, isigulane sinokuba ne-graft yolusu esithathwe emlenzeni wabo. Oku kuphucula amathuba okuphulukisa ngokufanelekileyo, kunye nemiba yokukhanyela ayifumanekanga njengoko umnikeli kunye nommkeli abafanayo.
U-Allograft: olu hlobo lokutshintshwa ngumntu ekufakweni komzimba kwezicubu, izitho, okanye i-corneas. Umnikeli ngumntu ohlukileyo kunommkeli kwaye akakwazi ukuba nomzimba ofanayo (njengamawele afanayo). Kukho umngcipheko ophawulekayo wokugatywa nolu hlobo lokufakelwa komzimba.
Isograft: olu hlobo lokutshintshwa lwenziwa phakathi komniki-mfuzo ofanayo kunye nommkeli, njengelinye iwele elifanayo.
Akukho mngcipheko wokugatya kule nkalo, njengoko umzimba awuqapheli i-twin's organ organ as foreign.
Xenograft: olu hlobo lokutshintshwa luphakathi kweentlobo ezahlukeneyo . Le yintlobo kwiintlobo zokutsalwa kwezilwanyana, ezinjengebhokhwe kubantu okanye kwihagu kubantu. Ngokuqhelekileyo, ezi zizinto ezihamba ngeethambo kodwa kwiimeko ezinqabileyo ziye zaguquka. Kukho ulindelo lobungozi obukhulu ngale ndlela yokufakelwa komzimba, kodwa ngokuphindaphindiweyo izicubu zenyama zibonelela ngengozi encinci yokulahlwa.
Iintlobo zabaxhasi bemizimba
Kukho iintlobo zontathu zabanikeli bomzimba ukuba baqaphele.
Umnikezeli weCadaveric: izicubu zomntu oshonile, izitho, kunye / okanye i-corneas zitshintshelwe kumntu ophilileyo.
Olu hlobo lunikelo lunomgangatho ofanayo nengozi njengalowo nawuphi umnikeli ongabandakanyekanga ngaphandle kokuba uvavanyo lwezofuzo lubonisa umdlalo phakathi komnikeli nommkeli olungcono kunokuba uqobo.
Abaphilayo abaxhamliweyo Abaxhasi: umniki-mntu ophilileyo unikela isigqeba kwisihlobo esinesidingo sokufakelwa komzimba. Ukutshintshwa kungathi kube lula ukuba kunqatshelwe ngenxa yokufaniswa kofuzo phakathi komnikeli nommkeli.
Umxhasi we-Altruistic: umnikeli ophilayo ukhetha ukunika ilungu kummkeli ongathandaniyo. Olu hlobo lomnikelo linomgangatho ofanayo wokungatshatyalaliswa njengalowo nawuphi umnikeli ongabandakanyekanga ngaphandle kokuba umnikeli kunye nommkeli ngumdlalo omhle kakhulu wemfuza.
Ukulahlwa komzimba
Uninzi lwezinto eziye zenziwa eUnited States ziyakuthi ziguqule izicubu . Ezi zifakelo zingapha isithambo, iigaments, i-tendon, iigraves zentliziyo, okanye i-graft ye-skin. Kwababamkeli kukho ezinye iindaba ezilungileyo kakhulu: ababanako ukuvalelwa kwezi zicubu .
Kubalamkeli bamalungu, ukulahlwa kwilungu elitsha kuyinkxalabo ebaluleke kangaka ukuba kufuna ukubeka iliso rhoqo ngokusebenza kwegazi, unyango lwemihla ngemihla kunye neendleko ezinkulu. Ukugatya kuthetha ukuba umzimba uyalahla ilungu elitsha kuba libona njengowomhlaseli wamanye amazwe ofana nesifo esingafunekiyo. Iimeko zokungalahlwa zihlala zixhalabisa abantu abafake izicelo zokubakholisa ngenxa yokuba ukugatywa kungachaza ukubuyela kwindlela yokuguqula i-dialysis okanye ukufa ngenxa yokuhluleka komzimba.
Indlela yoKhuseleko lweMistim esebenza ngayo
I- immune system yinkimbinkimbi kwaye iyinkimbinkimbi, kwaye kwiimeko ezininzi kunomsebenzi omangalisayo wokugcina umzimba womntu kakuhle. Amasosha omzimba enza izinto ezininzi, ukukhusela umzimba kwiintsholongwane, iintsholongwane, nezifo kunye nokunceda inkqubo yokuphilisa. Ukuthi isistim somzimba esiyinkimbinkimbi siyinkimbinkimbi ngokwenene, njengoko zonke iincwadi zezifundo zibhalwa kwi-immune system kunye nendlela ekhusela ngayo umzimba.
Ngaphandle kwesistim somzimba, asiyi kusinda ebusaneni njengoko singenakukwazi ukulwa ne-bhakteria encinci-ukunyanzeliswa kwanokuba kubanda kungabangela ukufa. I-immune system iyakwazi ukuchonga oko kukuthi "yedwa" kwaye ingowomzimba kwaye ingachonga ukuba yiyiphi "enye" kwaye iyilwe.
Le nkqubo isebenza ngokufanelekileyo ekugcineni umntu ngokufanelekileyo nokugcina izinto ezimbi emzimbeni, okanye ukulwa nayo xa ingena emzimbeni. Amasosha omzimba ahlale egcina izinto zingena kwimiphunga okanye igazi okanye ukudala usulelo, kodwa luyimpumelelo kakhulu ekulwa nabo.
Amasosha omzimba angabangela iingxaki xa engaboni kakuhle "uqobo" njenge "enye." Olu hlobo lwenkinga lubhekiswa ngokuthi "isifo esisodwa" kwaye sinoxanduva lwezifo ezinzulu ezifana ne-lupus, multiple sclerosis, i-ulcerative colitis, uhlobo lwesifo sikashukela , kunye ne-rheumatoid arthritis. Ezi zifo zibangelwa ngumzimba wokhuseleko ngaphandle kokuba zizathu ezifanelekileyo, kwaye iziphumo zingonakalisa.
I-System Immune kunye nokuKhatywa komzimba
Kwimeko yokudluliswa komzimba, inselele enkulu-emva kokufumana ilungu elifanelekileyo lokutshintshwa-kukugcina ilungu elitsha liphilile ngokukhusela ukukhishwa. Oko kuqhutyelwa ngamachiza, okanye amaninzi amachiza, anceda ukukhohlisa umzimba ukuba uqaphele "ezinye" njenge "uqobo." Ngokucacileyo, isimiso somzimba sokuzivikela kufuneka sicinge ukuba ilungu elitsha liyingxenye yomzimba, kunokuba ilungu ayikho.
Ukukhohlisa isistim somzimba kuyinselele kunokuba kubonakale kuba umzimba ulungile kakhulu ekuchazeni abahlaseli kuba kubalulekile ebomini. Kwinkoliso yabantu, i-immune system iba ngakumbi kwaye iyomeleleka kwiminyaka yokuqala yokuphila kwaye ikwazi ukulwa nokusuleleka kwintsholongwane kunyaka ngamnye owedlula kakuhle.
Uphando lukunceda ukutshintsha izigulane ziphumelele imfazwe ekuchaseni ukutshintshwa, kunye nesifo se-graft versus host, ngokukunceda ngokuchanekileyo indlela umzimba wokuzivikela ngayo udibanisa umzimba kunye nesigqeba ngokuthi "enye" emva kokutshintshwa. Ukufumanisa ukuba yiyiphi inxalenye yesistim somzimba sokuqalisa umzimba eqala amanyathelo amaninzi ekugatheni ukuba ekugqibeleni indlela yokukhusela ingadalwa.
Yintoni Edala Ukugatywa Kwegciwane?
Kukholelwa ukuba ubukho belo lungu luchazwe okokuqala ngokuthi "enye" xa iprotheni ye-SIRP-alpha ibopha kwi-receptor yamancinci kwi-cell cell. Ukususela apho, kwenzeka ukulandelelana kwamakhankethi oku kunokukhokelela ekugatyweni komzimba ngokupheleleyo xa kungabanjwa ngexesha okanye ukuba imithi ayiphumelelanga ekulawuleni impendulo.
Abaphandi bajonga ukuba njengeentlobo zegazi, kuya kubakho iintlobo ze-SIRP-alpha, kunye nokuvavanya umniki-mali kunye nommkeli abanokunciphisa umngcipheko wokutshintshwa kokutshintshwa ngaphambi kokuba utyando lwenziwe ngokuhambelana nomnikeli kunye nommkeli we-SIRP. Oku kunokunciphisa umngcipheko wokugatya, ukunciphisa inani lemithi efunekayo ekuthintela ukukhishwa, kwaye uninzi lwawo, lunceda iqumrhu lihlale ixesha elide kummkeli.
Ukunciphisa Umngcipheko Wokugatywa Ngaphambi kokutshintshwa
Kukho iindlela ezininzi eziye zenzeka ukuba ithuba lokulahlwa liye lahla ngaphambi kokuhlinzwa, okokuqala ngokubaluleka ngokuqinisekisa ukuba ummkeli kunye nomniki-mali banemifanekiso ehambelanayo yegazi, kwaye uqhubela phambili kwiimvavanyo kunye nobuchule obuninzi.
Ukuba umnikeli ungumnikeli ophilayo, isihlobo sisoloko sikhethwa kuba amathuba okugatywa ayancipha. Singafumana kwixesha elizayo ukuba le nto kukuba iintsapho zilungele ukufana kwe-SIRP-alpha, kodwa ngeli xesha liyingcamango eyodwa.
Ukuvavanywa kwe-Genetic kwenziwa kwakhona ukwenza umlinganiso onguhlobo lomnikeli. Oku kubaluleke ngakumbi ngokuguquka kweentso, njengoko iimpawu ezifanelekileyo ziphumela kwiminyaka emininzi yomsebenzi womzimba.
Lindela ukufumana uphando olwenza uncedo olungcono phakathi kokunikezela kunye ne-genetics yommkeli, kunye nophando oluthe xaxa ngokukhetha "ukucima" iinxalenye zesistim somzimba sokukhusela ukukhutshwa.
Ukunciphisa Umngcipheko Wokulahlwa Emva kokutshaliswa
Okwangoku, emva kokuqulunqwa komzimba sele kugqityiwe, iziphumo zebhabriki zesigulane kunye nohlobo lokutshintshwa ziya kunceda ukunyanzelisa uhlobo lwamayeza kunye nemali yonyango enikwa ukuthintela ukutshitshiswa.
IiLabs ziza kujongwa rhoqo kwiiveki kunye neenyanga emva kokutshintshwa, kwaye ke ukuhla kwexesha kuya kunciphisa izigulane ezininzi emva konyaka wokuqala. Sekunjalo, isigulane siya kufundiswa ukuba sifune iimpawu zokugatywa kwaye sihlale siphapheme ngokugcina impilo yabo.
Ukubukela ukulahlwa, ukulungiswa kwamachiza kusekelwe kwesoyiko okanye ukubonakala kwangoku kokugatywa, nokuphindwa kwezinto eziqhelekileyo. Oku kwenziwayo ukuqinisekisa ukuba isiqendu sokugatya siphendululwe ngummkeli wokutyelela ngokuqhelekileyo kufuneka abhekane nayo ukuze agcine impilo yakhe.
Kwixesha elizayo, njengoko kukho inkqubela phambili ekwenzeni ukukhutshwa kwe-immune system, izigulana zingadinga unyango olungaphantsi, ukubeka esweni ngaphantsi, kunye namava angcono okutshintshwa kwexesha elide. Oko kwathiwa, uphando lufanele lukhokele kumachiza asebenzayo aphezulu anokukwazi ukuyeka ukukhishwa okanye ukuba angayimisa inkqubela yokugatywa xa ifunyenwe.
> Imithombo:
> Abaphandi bacinga ukuba bafumene isizathu Sokulahlwa Kwemzimba Kwizigulana Zokutshiza. I-NPR. http://wesa.fm/post/researchers-think-theyve-found-cause-organ-reject-transplant-patients#stream/0
> Umnikeli we-SIRPA i-polymorphism inokumisela impendulo ye-immune ye-innate kwi-allogeneic grafts. Science Immunology. http://immunology.sciencemag.org/content/2/12/eaam6202